Irritable Bowel Syndrome (IBS) is one of the most common gastrointestinal problems, even though this condition can feel isolating, about 10 to 15 percent of the global population has IBS. IBS usually begins during early adulthood, rarely beginning after the age of 50. For those who have IBS, it simply means that the intestinal system does not work like normal, causing symptoms like abdominal pain, heartburn, diarrhea, and constipation.
What you eat can have a large impact on the severity of your symptoms. You may have already tried eating a healthier diet by cutting out fried or processed foods, but most people with IBS still experience symptoms even after making lifestyle changes. With the low-FODMAP diet, you can determine what foods trigger your IBS.
According to a study in PubMed, 76 percent of people with IBS who tried the low-FODMAP diet had a reduction in IBS symptoms. 82 percent saw a decrease in bloating. Flatulence, diarrhea, and constipation can also be significantly reduced with this diet.
Read on into the low-FODMAP diet for IBS, including what it is, how to follow it, and tips for success along the way.
What is the Low-FODMAP Diet?
FODMAPs are carbohydrates that can cause bloating and IBS symptoms because they are hard to digest. Instead of absorbing into your bloodstream, gut bacteria feed on these carbohydrates, producing gas and causing bloating.
The low-FODMAP diet is designed for people with IBS. The goal of this diet is to determine which high-FODMAP foods trigger your IBS symptoms, so you can then avoid those foods going forward and continue to eat foods that are low in FODMAPs.
Each letter in FODMAP represents a separate category of carbohydrates that can be hard to digest and cause IBS symptoms like bloating, gas, diarrhea, and constipation.
F for Fermentable
Fermentable is the umbrella term to cover all FODMAPs. Fermentable foods contain carbohydrates that lead to bloating and gas when bacteria in your gut break them down.
Note that fermentable is not the same thing as fermented. Fermented foods, like yogurt or kombucha, contain probiotics that may reduce IBS symptoms rather than cause them.
O for Oligosaccharides
Oligosaccharides are a short-chain carbohydrate that is hard to digest. Fructans and galacto-oligosaccharides (GOS) are both in this category.
Foods in this category to avoid: barley, cashews, onions, garlic, plums, wheat, and more.
D for Disaccharides
Lactose is not in all dairy products, like aged cheeses and butter.
Foods in this category to avoid: cream cheese, ice cream, cow's milk, ricotta, and more.
M for Monosaccharides
Fructose, a sugar commonly found in fruits, is a monosaccharide. When a fruit contains more fructose than glucose, it becomes high-FODMAP.
Foods in this category to avoid: agave, asparagus, cherries, high fructose corn syrup, honey, mangoes, watermelon, and more.
P for Polyols
The A in FODMAP stands for and, while the P stands for polyols. Polyols are sugar alcohols that appear in some fruits and vegetables naturally but are also commonly used as sugar alternatives. Sorbitol and mannitol are two categories.
Foods in this category to avoid: apricots, cauliflower, mushrooms, nectarines, prunes, snow peas, sugar alcohol additives, and more.
How to Follow the Low-FODMAP Diet for IBS
The low-FODMAP diet is effective, but it is not necessarily intuitive. When looking at an apple, you may think that an apple is healthy, so it should be fine for this diet. Unfortunately, FODMAPs are not that simple. An apple is high in the monosaccharide called fructose and therefore is not low in FODMAPs and can trigger IBS symptoms.
This diet is a multi-step process that involves an elimination phase, followed by reintroduction and personalization. Here is a guide to starting the low-FODMAP diet:
Step 1: Talk to Your Gastroenterologist
Although the low-FODMAP diet can provide great relief to people with IBS, this diet is not for everyone. The low-FODMAP diet requires planning, trial-and-error, patience, and guidance. Make sure to talk to a gastroenterologist before starting this diet. They will let you know if they think it is right for you based on your IBS diagnosis, symptoms, and symptom severity. Your gastroenterologist may also refer you to a registered dietitian who is experienced with managing IBS symptoms through the low-FODMAP diet for more guidance.
Step 2: Elimination
While the list of "not allowed" foods is long at first, the goal of this diet is to determine which ones trigger your symptoms. Some FODMAP foods and even whole categories may not bother you. That is why you will need to eliminate all high-FODMAP foods and quantities from your diet temporarily.
During the elimination phase, you will have to stop eating all high-FODMAP foods until your IBS symptoms improve. This may take between 2 and 8 weeks. It will take planning and patience.
Step 3: Reintroduction
Once your IBS symptoms have improved, and you feel continued relief, you can start slowly reintroducing different FODMAP categories one at a time. In this testing stage, you will eat a food from a FODMAP category and then wait a few days to see if your IBS symptoms return.
If symptoms do return, you will have to go back to the elimination phase. The good news is that now you know an IBS trigger. If symptoms don't return, you can try another food from that same category or move onto the next category. Repeat this process until you finish all categories.
Step 4: Personalization
The personalization phase is the end goal of the low-FODMAP diet. Here, you can begin eating some high-FODMAP foods if they didn't bother you, a lesser quantity of some foods, and low-FODMAP foods. The low-FODMAP diet for IBS is meant to be sustainable and worthwhile after the challenging elimination and reintroduction phases.
Keep in mind that some IBS triggers are not FODMAPs. You can follow this same process to determine other triggers as well.
Gastroenterologists Can Help Treat IBS
The low-FODMAP diet can be extremely beneficial for people with IBS, but we understand that it can be confusing and challenging. The gastroenterologists at GI Associates in Jackson, MS can help you learn how to identify your triggers, what lifestyle changes can improve your quality of life, and what new standards of treatments are available for your IBS. If you want to get started on the low-FODMAP diet, have any questions, or are wondering if you have IBS, please schedule an appointment today.